| NPI | 1467826495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130005) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 734195) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 734195) | |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2022-07-13 |